在医疗补助保险个人中,自我报告和计费的产后访问的差异
Meghan Bellerose1, Jamie R Daw2, Maria W Steenland3
1Department of Health Services, Policy, and Practice, Brown University School of Public Health, Providence, Rhode Island.
JAMA network open
|December 27, 2023
概括
医疗补助申请可能会低估分娩后访问的个人在分娩后更换保险. 了解保险过渡是准确产后护理估计的关键.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 孕产妇健康 孕产妇健康
- 医疗保险 医疗保险 医疗保险
背景情况:
- 国家医疗补助计划正在实施政策,以加强产后医疗保健的获取.
- 准确测量产后访问利用率对于评估政策成功至关重要.
- 不同的数据来源之间存在差异,用于估计产后访问率.
研究的目的:
- 评估从怀孕风险评估监测系统 (PRAMS) 和医疗补助申请中产后访问数据之间的差异.
- 确定分娩后的保险过渡是否与这些数据源不一致有关.
主要方法:
- 南卡罗来纳州的一项横截面研究,涉及产后患者在分娩时获得医疗补助.
- 将PRAMS调查答案 (2017-2020年) 与医疗补助申请 (住院患者,门诊患者,医生) 联系起来.
- 使用调查加权后勤回归来分析保险过渡和数据源不一致之间的关联.
主要成果:
- 观察到一个显著的分歧:30.3%的参与者显示PRAMS和医疗补助申请之间的差异.
- 大多数分歧 (27.2%) 涉及在没有相应的医疗补助申请的情况下向PRAMS报告访问.
- 从医疗补助到私人保险的过渡或在分娩后失去保险与数据源协议的增加有关.
结论:
- 医疗补助申请可能会低估产后访问,特别是对于转换到其他保险或失去保险的人来说.
- 纳入保险过渡数据可能会提高基于索赔的产后护理估计的准确性.
- 调查结果强调,在评估产后医疗保健利用时,需要考虑保险动态.
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